Re: Vessel size on ultrasound

[Cheryl]

Your I-look has measuring ability so there is no guess work in what size the vessel is.  Of course when the depth is greater, the vein looks smaller, but the machine accommodates for that and it adjusts the size accordingly.   When placing PICC's I like to decrease the blood flow no more that 50 % in the vessel.  If the patient is hypercoagulable, then 50% is too much and I will go for less.  A 3F PICC is 1 mm while a 6F is 2mm.  Therefore, when measuring the vessel size, I can decide how large the vein has to be based on the catheter size and the underlying coagulability factors of the patient.  If the vein is too small at one place, the I simply move up the arm until it is large enough to accommodate the catheter.    The Site Rite 5 is pretty cool too.  The vein is magnified so much that it is pretty easy to see the approximate size of the vein by using the "hash marks" on the side of the screen.    I like to document the size of the vessel when charting, especially for placing the triple lumen by Bard.  I try to look at liability issues, and think that I would be a little better off in a court of law, if I had actually measured the vessel size and then decided if that patient could safely accommodate that size of catheter.  That's just my personal opinion though.   You can't go wrong with either machine as far as being safe with measuring.  Only difference is that the I-look will give you an exact size.  One last thing......I measuring the vein without the tourniquet.  And I measure in the smallest area of the vein.  I don't really care what size the vessel is with a tourniquet, since the PICC is in the arm the whole time without a tourniquet.     Cheryl Kelley West Virginia University Hospitals [EMAIL PROTECTED] 304-823-3196 304-669-3061